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Background@#Duloxetine is an antidepressant that is also useful in chronic neuropathic and central origin pain. In this study, the role of duloxetine in decreasing acute postoperative pain after lumbar canal stenosis surgery is explored. @*Methods@#In this single center, triple blinded, and placebo-controlled trial, 96 patients were randomized for statistical analysis. The intervention group received oral duloxetine 30 mg once a day (OD) for 2 days before surgery, 60 mg OD from the day of surgery to the postoperative second day and 30 mg OD for the next 2 days (a total duration of 7 days). A placebo capsule was given in the other group for a similar time and schedule. The same standard perioperative analgesia protocols were followed in both groups. @*Results@#Total morphine consumption up to 24 hours was significantly decreased in the duloxetine group (p < 0.01). The time to the first analgesia requirement was similar in both groups but the time to the second and third dose of rescue analgesia increased significantly in the duloxetine group. The time to ambulation was decreased significantly (p < 0.01) in the duloxetine group as compared to the placebo group. Pain scores remained similar during most of the time interval. No significant difference was observed in the complication rate and patient satisfaction score recorded. @*Conclusions@#Duloxetine reduces postoperative pain after lumbar canal stenosis surgery with no increase in adverse effects.
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INTRODUCTION:Undernutrition is widely prevalent and major cause of morbidity and mortality in children under five years of age in India. Mortality among children with undernutrition is nine times more than well-nourished children. Even with the establishment of the Nutritional Rehabilitation Centre (NRC), data on undernutrition has not improved from NFHS -3 to NFHS- 4.OBJECTIVE:The primary objective of the study was to to evaluate the clinical profile of Severe Acute Malnutrition patients and to evaluate effect of socio-economic status on the outcome of management of children with SAM. MATERIALAND METHODS:Aobservational study was carried out among 61 undernourished children of 6-59 month of the age admitted under Nutritional Rehabilitation Centre of a tertiary care institute from December 2015 to December 2016.Demographic, clinical presentation, anthropometry, laboratory tests, hospital stay & outcome indicators were recorded. Modified Kuppuswamy classification was used to categorise socio-economic status of patients. Patients were followed up after 15 days and 1 month of discharge.RESULTS: -A total of 61 children with SAM were analyzed. Among them 64.94% were below the age of two years. Proportion of severely wasted, severely stunted and severe underweight children were 91.8%, 88.52%, and 91.97% respectively. 21.31% of the study participants had edema. Most common co morbidity was respiratory tract infection (42.62%). Most common clinical feature was loss of subcutaneous fat prevalent in (65.57%) and sparse hair (47.54%) amongst children enrolled in study. Average weight gain was 13.05 g/kg/day Among 61 patients, 62.29% recovered while,16.40% and 21.31% had inadequate response and failure to response, respectively on discharge. while 65.58% participants came for complete of all 2 follow ups, Among patients who came for complete follow-up 50.58% were recovered, 1.64% had relapse, 6.56% patients inadequate response and 6.56% patients were failed to show response.CONCLUSION-NRC provides life saving care.Acute gastroenteritis and respiratory tract infection were significantly associated with under nutrition in our study. loss of subcutaneous fat most common clinical presentation. In oue study NRC is affective in management with 62.29% recovery rate and 0% mortality, Maternal education, paternal education, socioeconomic status was not significantly associated in our study.